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A comparative study of a premature infant formula and preterm breast milk for low birthweight infants
Insights
Preterm milk (PTM) fed to low birthweight (LBW) infants showed slower growth and poorer biochemical outcomes compared to premature infant formula. Formula or mixed feeding resulted in superior weight gain and anthropometric measurements for LBW infants.
Area of Science:
- Neonatology
- Pediatric Nutrition
- Infant Growth and Development
Background:
- Preterm milk (PTM) is increasingly used for low birthweight (LBW) infants due to its unique composition.
- There is ongoing debate regarding whether PTM alone adequately meets the nutritional requirements of LBW infants.
- Clinical tolerance and various infant parameters need comparison across different feeding strategies.
Purpose of the Study:
- To compare clinical tolerance, anthropometric, biochemical, and hematological parameters in LBW infants.
- To evaluate infants fed exclusively with PTM, a premature infant formula (Alprem), or a combination of both.
Main Methods:
- A feeding trial involving 90 LBW infants (1000-1750 g birthweight) was conducted.
- Infants were divided into three groups: exclusive Alprem (Group A), mixed Alprem and PTM (Group B), and exclusive PTM (Group C).
- Data collected included birth characteristics, weight gain, length, head circumference, and biochemical/hematological markers over a mean of 42 days.
Main Results:
- Infants fed Alprem (Groups A and B) exhibited significantly greater weight gain (18.1 and 17.6 g/kg/day, respectively) compared to those fed PTM (Group C, 13.0 g/kg/day).
- Weight gain in Groups A and B exceeded predicted intra-uterine growth rates, while Group C approximated it.
- Alprem-fed infants showed superior growth in length and head circumference; PTM group had lower serum phosphorus, iron, albumin, urea, and higher zinc and alkaline phosphatase.
Conclusions:
- Exclusive PTM feeding resulted in suboptimal growth and biochemical profiles in LBW infants compared to formula or mixed feeding.
- Premature infant formula (Alprem) or a combination with PTM supported better weight gain and anthropometric development.
- LBW infants fed PTM required supplementation for calcium, sodium, vitamins, and energy, indicating potential nutritional inadequacy of PTM alone.
Abstract:
Although the unique composition of preterm milk (PTM) has led to its increasing use in feeding of low birthweight (LBW) infants, controversy exists as to whether such milk adequately meets their requirements. This study compares the clinical tolerance and anthropometric, biochemical and haematological parameters of LBW infants fed exclusively with their own mother's PTM, a premature infant formula (Alprem; Nestlé Australia) and a mixture of PTM and Alprem. Of 90 enrolled LBW infants (1000-1750 g birthweight), 78 completed the feeding trial for a mean duration of 42 days. Twenty-eight babies were fed Alprem (Group A), 31 received a mixture of Alprem and PTM (Group B) and 18 received PTM (Group C). Babies in Groups A and B were smaller, less mature and more asphyxiated at birth than those in Group C. Weight gain from full enteral feeding was greater in Group A (18.1 g/kg per day) and Group B (17.6 g/kg per day) than in Group C (13.0 g/kg per day). Throughout the trial, weight gain in Groups A and B exceeded predicted intra-uterine growth rates, whereas that for Group C approximated the predicted intra-uterine growth rates. Growth rates of length and head circumference were also greatest in the Alprem-fed babies. Infants receiving PTM were supplemented with calcium, sodium, vitamins and energy, whereas the only three infants requiring mineral supplementation in the Alprem group were those receiving Frusemide therapy for chronic lung disease. lower serum concentrations of phosphorus, iron, albumin and urea, and higher zinc and alkaline phosphatase concentrations were found in infants receiving PTM (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)